|
|
|
| Effect of improvement of standard use of magnesium sulfate in the pregnancy outcomes of patients with severe pre-eclampsia |
| FU Jing XU Yinyan |
| Department of Pharmacy, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Jiangsu Province, Nanjing 210004, China |
|
|
|
Abstract Objective To evaluate the pharmacy monitoring outcomes of patients with severe pre-eclampsia by promoting the standard use of magnesium sulfate after pharmaceutical care. Methods From July 2016 to June 2017, the medical records of patients with severe pre-eclampsia admitted to Women’s Hospital of Nanjing Medical University were collected and as control group (178 cases). Pharmaceutical care plan was formulated from July to December 2017. Patients with severe pre-eclampsia admitted from January to December 2018 were selected as intervention group (185 cases). The results of pharmaceutical intervention were recorded. The use of magnesium sulfate before pregnancy, after pregnancy and within 32 weeks of pregnancy, the treatment schedule and pregnancy outcomes were compared between the two groups. Results The number of overall utilization of magnesium sulfate, the utilization of prenatal magnesium sulfate, the utilization of postpartum magnesium sulfate, the utilization of both prenatal and postpartum magnesium sulfate in intervention group were larger than those in control group (P < 0.05). There were no significant differences in the daily dose and duration of magnesium sulfate maintenance, postpartum magnesium sulfate administration time, total prenatal and postpartum medication time, and the number and level of magnesium ion monitoring between two groups (P > 0.05). The number of utilization of magnesium sulfate in intervention group was larger than that in control group (P < 0.05). There was no significant difference in the incidence of utilization of magnesium sulfate between two groups (P > 0.05). There were no significant differences in the eclampsia, mode of delivery, time of termination of pregnancy and average weight of all fetuses between two groups (P > 0.05). The duration of pregnancy in intervention group was longer than that in control group (P < 0.05). Conclusion Magnesium sulfate in preventing eclampsia in patients with severe pre-eclampsia is still lack of clinical use. By implementing pharmaceutical care measures, the standard use of magnesium sulfate can be promoted and also improve the pregnancy outcomes.
|
|
|
|
|
|
[1] 杨欣，吴久玲.257例重度子痫前期/子痫硫酸镁应用现状分析[J].中国妇幼保健，2012，27（14）：2193-2195.
[2] 杨悦旻，徐先明.妊娠期高血压的解痉治疗[J].世界临床药物，2017，38（12）：810-814.
[3] WHO Recommendations for Prevention and Treatment of Pre-eclampsia and Eclampsia [EB/OL]. http://whqlibdoc.who.int/publications/2011/9789241548335_eng.pdf.
[4] Long Q，Oladapo OT，Leathersich S，et al. Clinical practice patterns on the use of magnesium sulphate for treatment of pre-eclampsia and eclampsia：a multi-country survey [J]. BJOG，2017，124（12）：1883-1890.
[5] 李静静，唐锐恒，唐莲，等.硫酸镁在重度子痫前期患者中血镁浓度不达标的相关因素分析[C].中国药理学会治疗药物监测研究专业委员会会议论文集，2019：2.
[6] 杨孜.妊娠期高血压疾病在真实临床世界实践之辨析[J].中国实用妇科与产科杂志，2019，35（4）：408-416.
[7] 妊娠期高血压疾病学组.妊娠期高血压疾病诊治指南版[J].中华妇产科杂志，2015，50（10）：721-728.
[8] American College of Obstetricians and Gynecologists. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on hypertension in pregnancy [J]. Obstet Gynecol，2013，122（5）：1122-1131.
[9] ACOG Practice Bulletin No.202：gestational hypertension and pre-eclampsia [J]. Obstet Gynecol，2019，133（1）：e1-e25.
[10] Aasreud M，Lewin NS，Innvaer S，et al. Translating research into policy and practice in developing countries：a case study of magnesium sulphate for pre-eclampsia [J]. BMC Health Serv Res，2005，5（1）：68.
[11] Geetanjali K，Umesh C，Anjali J，et al. Availability and use of magnesium sulphate at health care facilities in two selected districts of North Karnataka，India [J]. Reproduct Health，2018，15（Suppl 1）：91.
[12] Lotufo FA，Parpinelli MA，Osis MJ，et al. Obstetrician’s risk perception on the prescription of magnesium sulfate in severe preeclampsia and eclampsia：a qualitative study in Brazil [J]. PLoS One，2017，12（3）：e0172602.
[13] Magee LA，Miremadi，Li J，et al. Therapy with both magnesium sulfate and nifedipine does not increase the risk of serious magnesium-related maternal side effects in women with pre-eclampsia [J]. Am J Obstet Gynecol，2005，193（1）：153-163.
[14] Berhan Y，Berhan A. Should magnesium sulfate be administered to women with mild pre-eclampsia? A systematic review of published reports on eclampsia [J]. J Obstet Gynaecol Res，2015，41（6）：831-842.
[15] Agudelo CA，Romero R. Antenatal magnesium sulfate for the prevention of cerebral palsy in preterm infants less than 34 weeks’ gestation：a systematic review and meta-analysis [J]. Am J Obstet Gynecol，2009，200（6）：595-609.
[16] 中华医学会妇产科学分会产科学组.早产临床诊断与治疗指南（2014）[J].中华围产医学杂志，2015，18（4）：241-245.
[17] Magee LA，Silva DA，Diane S，et al. No.376-Magnesium Sulphate for Fetal Neuroprotection，SOGC Clinical Practice Guideline [J]. J Obstet Gynaecol Can，2019，41（4）：505-522.
[18] Sibai BM. Diagnosis and management of gestational hypertension and pre-eclampsia [J]. Obstet Gynecol，2003， 102（1）：181-192.
[19] Chieko S，Yukiyasu S，Shota K，et al. Introduction of management protocol for early-onset severe pre-eclampsia [J]. J Obstet Gynaecol Res，2017，43（4）：644-652.
[20] Ueda A，Kondoh E，Kawasaki K，et al. Magnesium sulphate can prolong pregnancy in patients with severe early-onset preeclampsia [J]. J Matern Fetal Neonatal Med，2016， 29（19）：3115-3120.
[21] Alexander JM，Mcintire DD，Leveno KJ，et al. Selective magnesium sulfate prophylaxis for the prevention of eclampsia in women with gestational hypertension[J]. Obstet Gynecol，2006，108（4）：826-832.
[22] 顾寅明，于锋，葛卫红.临床药师参与产科硫酸镁应用的监护模式与实践[J].中国临床药学杂志，2012，21（2）：102-104.
[23] Pratt JJ，Niedle PS，Vogel JP，et al. Alternative regimens of magnesium sulfate for treatment of preeclampsia and eclampsia：a systematic review of non-randomized studies [J]. Acta Obstet Gynecol Scand，2016，95（2）：144-156. |
|
|
|
